Dan Rather Reports
Episode Number: 503
Episode Title: Paging Doctor Fraud

Description: An investigation into the billions of dollars being stolen from this country’s Medicare system.

TEASE:
DAN RATHER (VOICE OVER)
TONIGHT. STEALING FROM MEDICARE. WE TAKE YOU TO THE FRONT LINES WITH FEDERAL AGENTS WHO ARE TRYING TO STOP BILLIONS OF TAX DOLLARS FROM BEING SIPHONED OUT OF THE SYSTEM.

KIRK OGROSKI, DEPARTMENT OF JUSTICE, “We treat doctors the same as we treat any other criminal. If they’re stealing money from the taxpayers, they get treated just like they’re stealing groceries out of a grocery store.”

RATHER (ON CAMERA)
GOOD EVENING. TONIGHT, GAMING THE SYSTEM IN A BIG WAY. WE START WITH AN INVESTIGATION OF MEDICARE. THE NATION’S INSURANCE SAFETY NET FOR SENIORS AND THE DISABLED. THE PROGRAM HAS BEEN A LIFESAVER FOR MILLIONS OF AMERICANS. IT’S ALSO BEEN CREDITED WITH KEEPING HEALTH CARE COSTS DOWN. BUT WITH BILLIONS OF DOLLARS IN PAYMENTS GOING OUT EVERY YEAR, THERE’S A LOT OF ROOM FOR FRAUD. IT’S NOT TOO STRONG TO SAY — MEDICARE IS BEING PILLAGED AND PLUNDERED. BUT WHAT DOES WASTE, ABUSE AND FRAUD ACTUALLY LOOK LIKE? AND WHO IS RESPONSIBLE FOR IT. IT TURNS OUT THOSE ARE QUESTIONS WITH MANY ANSWERS BECAUSE THE FRAUD AND THEFT IS SO WIDESPREAD. WE BEGIN TONIGHT WITH A SMALL GOVERNMENT AGENCY THAT HAS THE DAUNTING TASK OF CRACKING DOWN ON HEALTH CARE FRAUD.THEY ARE AGENTS ON ASSIGNMENT FROM THE DEPARTMENT OF HEALTH AND HUMAN SERVICES — OIG, THE OFFICE OF THE INSPECTOR GENERAL.

RATHER (VOICE OVER)
IT’S 6AM IN SUBURBAN DETROIT, AND THESE OIG AGENTS ARE ONE OF FOURTEEN TEAMS THAT ARE FANNING OUT ACROSS THE REGION FOR SIMULTANEOUS RAIDS AIMED AT DISMANTLING AN ALLEGED PHONY HOME HEALTH CARE RING.

UNIDENTIFIED MALE OIG AGENT
Zeola and Mark, I want you guys obviously with Dr. Raval.

ZEOLA CAREY, SPECIAL AGENT
We want all the financial documents that are found separated from everything else.

MALE OIG AGENT
Everybody set?

CAREY
As set as we’re gonna be…

MALE OIG AGENT
Okay, everybody be safe.

RATHER (VOICE OVER)
OIG IS HERE IS BECAUSE THIS ALLEGED FRAUD TARGETED MEDICARE, THE GOVERNMENT RUN INSURANCE FOR SENIORS… THAT MEANS THIS OPERATION – MONTHS IN THE PLANNING – IS ALL ABOUT RECOVERING YOUR TAX DOLLARS. THE BEST ESTIMATE IS THAT EVERY YEAR MEDICARE IS DEFRAUDED BY 60 BILLION DOLLARS. SOME OF THE SCHEMES ARE THE WORK OF OLD-FASHIONED HUCKSTERS AND SCAM ARTISTS AND SOME OF THEM ARE HATCHED IN THE BOARD ROOMS OF FORTUNE 500 COMPANIES. OIG AGENTS ARE RESPONSIBLE FOR TRACKING DOWN AS MUCH OF IT AS POSSIBLE, WHEREVER THE TRAIL LEADS.

(knocking on the door. “Police, search warrant!”)

RATHER (VOICE OVER)
THIS CAN BE A DANGEROUS BUSINESS.

FBI AGENT
Morning, how ya doin?

RATHER (VOICE OVER)
OIG AGENTS ARE ARMED WITH GUNS, BADGES AND ARREST WARRANTS. THEY ARE BACKED BY THE FBI AND LOCAL POLICE.

STEVE RINALDI, OIG
You go inside immediately in the door to the left…

RATHER (VOICE OVER)
STEVE RINALDI LEADS A GROUP OF AGENTS RESPONSIBLE FOR ARRESTING A MAN WHOM THEY SAY WAS POSING AS A DOCTOR, CREATING FALSE MEDICAL FILES ON PATIENTS HE NEVER HAD.

RINALDI
He’s hired by the facility to provide health care, but he’s actually unlicensed and has never been licensed.

RATHER (VOICE OVER)
JUST MINUTES LATER, RINALDI AND HIS TEAM GET THEIR MAN – THE ALLEGED FAKE DOCTOR IS LED OUT IN HANDCUFFS. A FEW MILES AWAY, ANOTHER GROUP OF AGENTS RAID THE MILLION DOLLAR HOME OF DR. PRAMOD RAVAL. RAVAL IS A REAL DOCTOR, BUT HE’S ACCUSED OF SELLING PATIENT NAMES TO THE HOME HEALTH COMPANY THAT ALLEGEDLY BILLED MEDICARE FOR $14.5 MILLION DOLLARS. THEN CAME THE SEIZING OF EVIDENCE – HUNDREDS OF BOXES WORTH OF IT, OUT OF DR. RAVAL’S CLINIC ALONE. HIS WAS ONE OF FOUR OFFICES RAIDED THIS MORNING, FILES, MEDICAL RECORDS, AND COMPUTERS – NOW THE PROPERTY OF OIG’S INVESTIGATORS. ALL TOLD 35 OIG AGENTS, ALONG WITH LOCAL AND FEDERAL LAW ENFORCEMENT, COOPERATED ON THE RAID. THEY’RE PART OF WHAT’S KNOWN AS A “MEDICARE STRIKE FORCE,” AN INTER-AGENCY APPROACH TO MEDICARE FRAUD THAT WAS PILOTED IN MIAMI AND NOW HAS SPREAD TO SEVEN CITIES. BY LUNCHTIME, THIRTEEN INDIVIDUALS HAVE BEEN ROUNDED UP. THE AGENTS HEADING INTO HARMS WAY WERE NOT THE ONLY PART OF THE DETROIT “STRIKE FORCE”. WHILE THEY WILL BE MAKING THE ARRESTS IN THE FIELD, SOMEBODY HAS TO MAKE THE CASES IN COURT. SO A GROUP OF LAWYERS FROM THE JUSTICE DEPARTMENT WAS ALSO BROUGHT INTO TOWN.

KIRK OGROSKI, DEPARTMENT OF JUSTICE
In the strike force we treat doctors the same as we treat any other criminal. If they’re stealing money from the taxpayers, they get treated just like they’re stealing groceries out of a grocery store. Read More→